Talking to Children about Death

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Parents of children with life-threatening conditions are expected to make difficult decisions every day. Among them may be whether to talk to their sick child and his or her siblings about the possibility of death. If parents choose to talk to their children about their sick child's prognosis, the palliative care team can be there to help.

Should I Talk to My Child About Death?

Palliative care professionals agree that children typically know more than their parents think they do. Parents can gauge what their children know through the questions children ask. If a terminally ill child asks, for example, "Am I going to die?" he or she may not want to hear "Everyone is going to die someday." Instead, this can be a signal that the child knows his or her condition is life-threatening.

Some professionals will recommend open and direct communication with children about the child's prognosis at all times. Others may say it's only necessary to tell the child as much as the child asks to know. All acknowledge that each family is different.

If parents avoid children's questions, the children may ask someone else or hold the questions in, which could result in unnecessary anxiety. Acknowledging rather than disregarding questions can build trust and show children that their concerns are important. This may increase the likelihood that children come to their parents with future questions.

During the course of a child's illness, the child and his or her siblings may feel left out. The child who is sick may recognize that parents always whisper or leave the room to talk to doctors. The siblings will notice that more attention is focused on the sick child. Without continued open communication, children may draw the wrong conclusions from these observations.

How Should I Talk to My Child About Death?

Experts advise parents to be honest and concrete in discussions about death. Avoid euphemisms. Adults use euphemisms to avoid uncomfortable subjects, but children, who think literally throughout a great deal of childhood, may not pick up on these cues.

If a parent tells a child whose sibling has died that the sibling is sleeping, the child may expect the sibling to wake up. If the parent says the sibling will not wake up, the child may fear going to sleep and not waking up.

Though the words are difficult to say, professionals agree that parents should use terms like "die," "dead," and "dying." If parents cannot say these words, the palliative care team can help explain as much as the parents want their children to know.